What is this article about?
Management of the second stage of labour can vary considerably. Even though research evidence seems to favour spontaneous pushing, directed pushing is still often used. Which method is best? As every midwife knows, slow and controlled birth of the baby is important to prevent perineal trauma. Lemos et al. (2017) note that there is still no consensus on an ideal strategy for pushing during the second stage, and as Edqvist et al. (2016) point out, there is still very little high-quality research comparing directed versus spontaneous pushing during the active second stage of labour.